While there’s a growing body of evidence addressing the relationship of childhood trauma to heart health, Telisa Spikes wanted to take “a deeper dive’’ into the experiences of Black adults.
To do so, the assistant professor at Emory University’s Nell Hodgson Woodruff School of Nursing used a unique dataset about healthy Black adults in Atlanta.
The study found an association for Black women between childhood trauma and greater arterial stiffening. Black men did not show that association, suggesting women might experience trauma and stress differently, Spikes said — with implications for their heart health.
The findings, published in the Journal of the American Heart Association, have deep roots in Atlanta. Spikes, the lead author of the study, started her career as a cardiovascular nurse at Emory Saint Joseph’s Hospital, where she often saw relatively young Black women with heart failure.
That experience inspired her to study stress and heart health among Black women.
Spikes and a team from Emory and Morehouse School of Medicine looked at data from just over 400 Black Atlantans who participated in the Morehouse-Emory Cardiovascular Center for Health Equity, or MECA.
The MECA study, which collected data between 2014 and 2019, focused on “the determinants of resilience” among Black adults. People with a history of serious cardiovascular disease or other conditions were excluded from the study, meaning participants were in relatively good health.
MECA used a standard, 27-item questionnaire that asked participants to self-report on childhood trauma, including physical, emotional, and sexual abuse. It also measured markers of vascular health among participants.
Black women showed an association between experiences of childhood trauma and higher measures on two of the three vascular markers related to the stiffness of arteries, or the hardening of their walls. That can hinder blood flow and cause the heart to work harder as a pump. Over time this can lead to heart failure and stroke.
The Black men in the MECA study, on the other hand, did not demonstrate an association between childhood trauma and those markers.
Stiff arteries contribute to high blood pressure, a leading risk factor for heart attack and stroke. Black Americans tend to develop cardiovascular disease earlier in life than other racial or ethnic groups, Spikes said.
Black women face unique chronic stressors “due to that intersectional identity of being not only Black but also being female,” Spikes said. Those include the wage gap, caregiving responsibilities and a greater likelihood of being single heads of household.
Spikes added that Black women who experienced childhood trauma could have worse arterial health due to factors like lack of physical activity and unhealthy diet.
Or women could have a different physiological stress response than men, she said, adding that prolonged stress can damage cardiovascular health.
The stronger association between childhood trauma and stiff artery markers “raises important questions about possible biological and social differences in how stress affects the body,” Paula Rodriguez-Miguelez, an associate professor at Virginia Commonwealth University, said in an email. She agreed to comment on the study and was not part of the research.
She explained that all people experience stress in everyday life but chronic stress like “years of bullying at school or growing up in a challenging environment” can cause the body to “continuously release stress hormones like cortisol.”
Both Rodriguez-Miguelez and Spikes said that the damage caused by chronic stress and inflammation is “silent” and does not cause symptoms but contributes to high blood pressure and, often, heart disease and stroke.
Like Spikes, Rodriguez-Miguelez said the increased arterial stiffening among women with childhood trauma could also be due to behavioral factors like unhealthy diet, lack of exercise, and smoking.
“Individuals who experience childhood adversity may be more likely to develop unhealthy coping mechanisms,” Rodriguez-Miguelez said.
On the clinical front, Spikes suggested integrating a childhood trauma measure into primary care screenings.
Atlanta is a good place to look at Black heart health, Spikes said, because of its large Black population and high concentration of health researchers.
“Given the health challenges and health disparities of Black populations as well as the increase in health researchers of color [in Atlanta], there is a greater interest to develop strategies and interventions that will mitigate these disparities,” Spikes said.
She is now recruiting participants for a National Institutes of Health-funded study that looks at chronic stressors in Black women 35 to 44 years old. She’s expecting results next year.
Spikes is concerned about potential cuts to NIH funding and wants the results from her research about heart disease in marginalized communities to be shared “to highlight why funding this type of work matters.”
Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org. This story comes to GPB through a reporting partnership with Healthbeat.
